Predictors of Disruptions in Breast Cancer Care for Individuals with Schizophrenia

Irwin, Kelly E.; Park, Elyse R.; Shin, Jennifer; Fields, Lauren; Jacobs, Jamie M.; Greer, Joseph A.; Taylor, John B.; Taghian, Alphonse G.; Freudenreich, Oliver; Ryan, David P.; Pirl, William F.

doi:10.1634/theoncologist.2016-0489

Cited by 34 publications

(50 citation statements)

References 38 publications

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“…For instance, patients with psychiatric comorbidities and breast cancer are more likely to experience deviations in stage-specific treatments, resulting in poor 5-year disease recurrence rates. 7 …”

Section: Discussionmentioning

confidence: 99%

The impact of psychiatric utilisation prior to cancer diagnosis on survival of solid organ malignancies

et al. 2019

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BACKGROUND: Among patients with cancer, prior research suggests that patients with mental illness may have reduced survival. The objective was to assess the impact of psychiatric utilisation (PU) prior to cancer diagnosis on survival outcomes. METHODS: All residents of Ontario diagnosed with one of the top 10 malignancies (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) were included. The primary exposure was psychiatric utilisation gradient (PUG) score in 5 years prior to cancer: 0: none, 1: outpatient, 2: emergency department, 3: hospital admission. A multivariable, cause-specific hazard model was used to assess the effect of PUG score on cancer-specific mortality (CSM), and a Cox proportional hazard model for effect on all-cause mortality (ACM). RESULTS: A toal of 676,125 patients were included: 359,465 (53.2%) with PUG 0, 304,559 (45.0%) PUG 1, 7901 (1.2%) PUG 2, and 4200 (0.6%) PUG 3. Increasing PUG score was independently associated with worse CSM, with an effect gradient across the intensity of pre-diagnosis PU (vs PUG 0): PUG 1 h 1.05 (95% CI 1.04-1.06), PUG 2 h 1.36 (95% CI 1.30-1.42), and PUG 3 h 1.73 (95% CI 1.63-1.84). Increasing PUG score was also associated with worse ACM. CONCLUSIONS: Pre-cancer diagnosis PU is independently associated with worse CSM and ACM following diagnosis among patients with solid organ malignancies.

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Section: Discussionmentioning

confidence: 99%

The impact of psychiatric utilisation prior to cancer diagnosis on survival of solid organ malignancies

et al. 2019

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“…Increased expression of Gal/GalNAc associated enzymes and glycan structures are common in various cancers (Schneider et al, 2017;Xie et al, 2018Xie et al, , 2016Zhou et al, 2013Zhou et al, , 2012 and schizophrenia patients diagnosed with cancer tend to have a longer delay to diagnosis, worse treatment outcomes, and higher mortality rates (Abdullah et al, 2015;Bergamo et al, 2014;Irwin et al, 2017;Ishikawa et al, 2016;Lawrence et al, 2000;Safdieh et al, 2017;Sathianathen et al, 2019;Zhuo et al, 2017). Since we have identified decreased levels of B4GALT1 and GALNT16 in schizophrenia, it is possible that established biomarkers for cancer diagnosis do not have the same degree of predictive accuracy for schizophrenia patients.…”

Section: Discussionmentioning

confidence: 92%

Altered protein expression of galactose and N-acetylgalactosamine transferases in schizophrenia superior temporal gyrus

Mueller

Mallepalli

Meador‐Woodruff

2019

Preprint

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Abnormal glycosylation in schizophrenia brain has been previously implicated in disruptions to protein trafficking, localization, and function. Glycosylation is an enzyme-mediated posttranslational modification and, along with reports of altered glycan biosynthesis and abnormal glycan levels in peripheral fluids, growing evidence for altered glycosylation pathway activity in schizophrenia prompted investigation of specific enzymes which may be responsible for these abnormalities. Glycosylation is a highly variable yet tightly controlled cellular process and, depending on the molecule(s) affected, altered glycan modifications can influence the trajectory of many key functional pathways. In a preliminary gene array study, abnormal transcript expression of 36 glycosylation-associated enzymes was identified in schizophrenia brain. Subsequently, protein expression abnormalities of enzymes which act on glucose (UGGT2), mannose (EDEM2), fucose (FUT8, POFUT2), and N-acetylglucosamine (MGAT4A, B3GNT8) have been reported in this illness. The current study investigates protein expression levels by western blot analysis of the galactose and N-acetylgalactosamine (GalNAc) transferases B3GALTL1, B4GALT1, C1GALT1, GALNT2, GALNT7, GALNT16, and GALNTL5, as well as a related chaperone protein, COSMC, in superior temporal gyrus of age-and sex-matched pairs of schizophrenia and non-psychiatrically ill comparison subjects (N = 16 pairs). In schizophrenia, reduced β-1,4-galactosyltransferase 1 (B4GALT1) and polypeptide GalNAc-transferase 16 (GALNT16) were identified. These findings add support to the hypothesis that dysregulated glycosylation-associated enzyme expression contributes to altered protein glycosylation and downstream substrate-specific defects in schizophrenia.

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“…Due to the higher mortality from smoking-related illnesses than the general population, patients with schizophrenia are encouraged to receive pharmacotherapy and behavioral treatments to give up smoking [45]. Moreover, disruptions in the diagnosis and treatment of breast cancer are noticeable for patients with schizophrenia and result in adverse outcomes, including cancer recurrence [46]. Poor diagnostic evaluation and belated stageappropriate treatment in lung cancer care are common among patients with schizophrenia and lead to poor outcomes [47].…”

Section: Main Findings and Comparison With Other Studiesmentioning

confidence: 99%

Mortality of site-specific cancer in patients with schizophrenia: A systematic review and meta-analysis

Long

Yuan

et al. 2019

Preprint

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Background: Numerous studies have reported contradicting results on the relationship between cancer mortality and schizophrenia. Our aim is to quantify the mortality rate of common site-specific cancers among patients with schizophrenia and to synthesize the available research evidence. Method: We performed a systemic search of the PubMed, EMBASE and Web of Science databases. Studies reporting the mortality rate of different cancer in patients with schizophrenia were included. A random-effects model was applied to calculate the pooled relative risks (RRs) with 95% confidence intervals (95%CIs). Results: Seven studies consisting of a total of 1,162,971 participants with schizophrenia were included in this meta-analysis. Data regarding mortality risk of breast, colon, lung and prostate cancer among schizophrenia patients were subjected to quantitative analysis. Pooled results showed significant increases in mortality risk of breast cancer (RR = 1.97, 95%CI 1.38–2.83), lung cancer (RR = 1.93, 95%CI 1.46–2.54) and colon cancer (RR = 1.69, 95%CI 1.60–1.80) in patients with schizophrenia compared with those in the general population or control group. The mortality risk of prostate cancer increased in male patients, although no significant difference was detected (RR = 1.58, 95% CI 0.79–3.15). Increased risks of mortality from lung and colon cancer were observed in female patients (RR = 2.49, 95%CI 2.40–2.59 and RR = 2.42, 95%CI 1.39–4.22, respectively) and elevated risks of mortality from lung and colon cancer in male patients (RR = 2.40, 95%CI 2.30–2.50 and RR = 1.90, 95%CI 1.71–2.11, respectively) were detected. Conclusions: Individuals with schizophrenia have a significantly high risk of mortality from breast, colon, and lung cancer and a high risk of mortality from prostate cancer.

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Predictors of Disruptions in Breast Cancer Care for Individuals with Schizophrenia

Cited by 34 publications

References 38 publications

The impact of psychiatric utilisation prior to cancer diagnosis on survival of solid organ malignancies

The impact of psychiatric utilisation prior to cancer diagnosis on survival of solid organ malignancies

Altered protein expression of galactose and N-acetylgalactosamine transferases in schizophrenia superior temporal gyrus

Mortality of site-specific cancer in patients with schizophrenia: A systematic review and meta-analysis

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